ABSTRACT There has been limited research comparing geropsychiatric patients residing in rural versus urban settings. With a sample of geropsychiatric inpatients from urban (n = 339) and rural (n = 30) areas, demographic and psychiatric characteristics were explored. On admission, rural patients were significantly less likely to live in a nursing home, but not on discharge. Rural patients also had more physical problems and anxiety/depression prior to admission, and were more physically agitated, verbally agitated, and anxious/depressed at discharge. Both urban and rural elderly improved significantly with inpa-tient treatment on almost all psychiatric variables. Pre-post test change scores on psychiatric variables revealed few differences in improvement between urban and rural elderly. Benefit of inpatient geropsychiatric treatment may be not only to improve rural patients' psychiatric symptomatology, but also to provide for a more structured and supervised discharge living environment.